vessel occlusion with the help of george Bishop (55). In 1957, a modified Cairns clip was used in two cases of aneurysm by Gibbs (55). Temporary clamping and moderate hypothermia in the treatment of aneurysms were reported by Suzuki et al. in 1969. The authors pointed that intermittent reperfusion allowed prolongation of the total time of temporary occlusion (52). After the late 1970s, there were an increasing number of reports on the use of precautionary temporary artery occlusion in the

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... al management of giant aneurysms (4, 20, 51, 53). ljunggren et al. reported that occlusion was well tolerated at the middle cerebral artery (MCA) for up to 20 minutes in 1983 (31). The routine use of both proximal and distal temporary clipping was pioneered by Suzuki (8). After Ausman's paper in 1985, many articles have reported the routine use of temporary artery occlusion in large series of patients (2, 8, 44). Preconditioning by exposure to sublethal hypoxic stress, hours or days before severe hypoxia, decreases cell death, and this resistance of the brain to injury is known as ischemic tolerance. Brief alternating periods of reperfusion-reocclusion at the beginning of reperfusion is defined as postconditioning. Cerebral ischemic pre/postconditioning protects against stroke, but is clinically feasible only when the occurrence of stroke is predictable. Brief, repetitive occlusion and release of the main trunk of a vessel during early aneurysm surgery or before long-lasting temporary artery occlusion may protect the brain against later possible vasospasm/ischemia.